Lumbar spinal fusion is a common technique to help patients with back pain, who have failed non-operative treatment.
There are many new surgical techniques that are being developed to improve the results of lumbar fusions. Minimally invasive spine surgery (MIS) for lumbar fusion is one of these newer techniques. One MIS technique is a procedure known as extreme-lateral lumbar interbody fusion (XLIF). During the XLIF procedure the lumbar spine is approached from the side through a small skin incision. The surgery is performed through a muscle that lies next to the lumbar spine known as the psoas muscle. This side entry means sensitive back muscles are not disturbed and no bone removal is required. This means less postoperative pain and early return to normal function.
Once this direct access to the spine is achieved, the surgeon is able to perform a standard discectomy (removing the intervertebral disc). After the disc material is removed, the surgeon is able to insert the implant through the same incision from the side. This spacer (cage) will help hold the vertebrae in the proper position to make sure that the disc height (space between adjacent vertebral bodies) is correct and to make sure the spine is properly aligned. This spacer together with the bone graft, is designed to set up an optimal environment to allow the spine to fuse at that particular segment.
Not everyone is a candidate for this surgery, you should consult a surgeon to see if you are an appropriate candidate.
The following video gives more information on the XLIF procedure.
Ronald Childs, MD, specializes in spine surgery and practices in our Fairfax office.